24 April 2015 Army Public Health Weekly Update not ... Library... · 24 April 2015 Army Public...

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24 April 2015

Army Public Health

Weekly Update

US Army Public Health Command

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Contents

US MILITARY

Personal technology use by US military service members and veterans An update

Service members are left in dark on health errors

Update Exertional rhabdomyolysis active component US Armed Forces 2010ndash2014

GLOBAL

DNA blood test detects lung cancer mutations

Drugs that activate brain stem cells may reverse multiple sclerosis

Ex-Googlers new breast cancer gene test cuts the cost to women

First infant MRI study finds babies feel pain like adults

Gene therapy Tame HIV used to cure disease

Global pandemic of fake medicines poses urgent risk scientists say

Global vaccination targets lsquooff-trackrsquo warns WHO

Rabies deaths higher than previously thought

Yet another study finds no link between MMR vaccine autism

EBOLA VIRUS DISEASE

Ebola lying in wait

WHO leadership admits failings over Ebola promises reform

INFLUENZA

Armed Forces Health Surveillance Center DoD Seasonal Influenza Surveillance Summary

CDC Weekly Influenza Surveillance Report

DoD Global Laboratory-Based Influenza Surveillance Program

Flu News Europe

Naval Health Research Center Febrile Respiratory Illness Surveillance Update

USAPHC US Army Influenza Activity Report

WHO Influenza Update

VETERINARYFOOD SAFETY

Doctors dont always ask about pet-related health risks

Goat plague hits poor farmers in Africa Asia wider vaccination needed FAO

Humans use of pain-relief creams proves fatal to felines

The Army Public Health Update is a summary of articles taken verbatim

from public sources to offer awareness of current health

issues and the media coverage given to them The articles do

not necessarily represent US Army Medical Department

opinions views policy or guidance and should not be construed or interpreted as

being endorsed by the US Army Medical Department

2

Performance Triad

The Total Family

Guide

The Total Family Guide to

enhancing your health with

sleep activity and nutrition

is now available for

download from the Health

Information Products

eCatalog

Texas ice cream maker recalls all products over Listeria

WELLNESS

Abuse-deterrent formulations put dent in opioid ODs

A surge in federal funding for Mental Health First Aid could make it as popular as CPR

Depression Mindfulness-based therapy shows promise

HIV cases lead Indiana to extend needle exchanges

HPV vaccine effective at multiple sites

Slippery slope Diet drugs no help for heart

USAFRICOM

Democratic Republic of the Congo Malaria outbreak in South Kivu

Libya Hundreds feared dead as boat capsizes off Libya coast

Niger shuts schools and vaccinates children to fight meningitis outbreak

Nigeria Pesticide the likely cause of Nigeria mystery disease

Somalia Somaliland abuzz from Ethiopias khat convoys

Tanzania Typhoid outbreak hits Zanzibar

Uganda Typhoid outbreak nears 2000

USCENTCOM

Syria Doctors testify at UN over Syria chemical attacks

Syria lsquoThey were just struggling to breathersquo

Yemen WHO says warfare has left Yemens health system near collapse

USEUCOM

Ukraine In rebel territory of Ukraine older residents fight to live

USNORTHCOM

US Alabama Montgomery spice victim number climbs to near 80

US Californians can now pay cash for health insurance at 7-Eleven

US Occupational traumatic injuries among workers in health care facilities mdash United States

2012ndash2014

US The FDA might finally crack down on homeopathy

US The rise of Powassan virus

US Top hospital ratings prove scarce in Medicares latest tally

USPACOM

China Hundreds of Chinese cities donrsquot meet air standards report finds

India Indian minister says 2000 girls killed every day

Myanmar Dengue on the rise in Mon State

USSOUTHCOM

Brazil seeing nearly half a million dengue cases in 1st three months of 2015 enlists Armyrsquos

support

PAHO reports small increase in chikungunya cases

Peru Dengue epidemic expands to 16 regions

3

Clinical Update

Multidrug-Resistant

Travelersrsquo Diarrhea

Clinicians frequently

prescribe antibiotics for

travelers so that they can

self-treat diarrhea if it

develops

Recent findings suggest

that travelers who take

antibiotics to treat diarrhea

are at increased risk of

becoming colonized with

resistant bacteria

specifically with extended-

spectrum β-lactamasendash

producing

Enterobacteriaceae

The risk is highest in South

Asia where 80 of

travelers who had diarrhea

and self-treated with

antibiotics became

colonized with these

organisms As shown in the

current Shigella outbreak

travelers who are infected

in other countries may

continue to shed

organisms after they return

to the United States

producing local foci of

infection

US MILITARY

Personal technology use by US military service

members and veterans An update

1 April ndash [The] three broad militaryveteran samples have personal technology habits that

are similar to those of their civilian peers Computers appear to be a valid target for health

research and intervention with military consumers both at home and on deployment Both

desktop and laptop machines remain in high personalnon-work use by active duty SMs

Guard Reserve and veterans Tablet devices also offer potential as mobile vehicles for

mobile health education and care at home Gaming devices are still popular both at home

and on deployment and may offer some opportunities for healthcare especially with the

advent of gaming methodology for behavior change The most vivid change in our data

over the two surveys is the extreme increase of mobile phone use at home in recent years

PTEC2 data show mobile phone use in our samples of the military community at home to be

as ubiquitous as it is in current civilian life More than 9 out of 10 active duty SMs Guard

Reserve and veterans reported owning and using mobile phones for a wide variety of

purposes Clearly for the moment at least mobile personal devices may offer the ideal

medium for accessible and portable health education and for intervention Mary Ann

Liebert Inc publishers


19 April - hellip Only 18 months ago did the Pentagon explicitly

allow [service members] to file complaints about their

treatment although some had done so earlier But even

then they are barred from learning the results of any inquiry

Under federal law investigations at military hospitals and

clinics are confidential hellip In scores of interviews active-duty

patients relatives and military medical workers described how in that information vacuum

attempts to ferret out the truth about suspected medical mistakes mdash through freedom-of-

information requests complaints meetings with military medical officials mdash produced

anodyne letters of condolence blanket denials of poor care or simply nothing at all ldquoThere

is just no transparency You canrsquot sue You have no insight into the processrdquo said Cheryl

Garner a military intelligence officer who retired last year ldquoAs active duty we just donrsquot

have much recourserdquo New York Times

Update Exertional rhabdomyolysis active component

US Armed Forces 2010ndash2014

March 2015 - Among active component US service members in 2014 there were 403

incident episodes of rhabdomyolysis likely due to physical exertion or heat stress

(ldquoexertional rhabdomyolysisrdquo) The annual incidence rates of exertional rhabdomyolysis

4

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the Weekly Update

An Army Public Health

Weekly Update is available

with articles classified up to

the SECRET level from the

USAPHC SIPRNet site

httpphcarmysmilmil

Look under Hot Topics amp

Current Issues

To access this version you

will need a SECRET

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account

Links

A-Z Index

About USAPHC

Army Public Health and

Health Information

Weekly Update Archives

Medical Surveillance

Monthly Report

Medical Threat Briefings

(AKO)

Request USAPHC Services

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Materials

USAPHC Homepage

USAPHC Training

Contact USAPHC

increased nearly 50 during 2010ndash2014 In 2014 the highest incidence rates occurred in

service members who were male younger than 20 years of age black non-Hispanic

members of the Marine Corps and Army recruit trainees and in combat-specific

occupations Incidence rates were higher among service members with homes of record

from the Northeast compared to other US regions Most cases of exertional

rhabdomyolysis were diagnosed at installations that support basic combatrecruit training

or major ground combat units of the Army or Marine Corps Medical Surveillance Monthly

Report

top of page

GLOBAL


17 April - Cancer DNA circulating in the bloodstream of lung cancer patients can provide

doctors with vital mutation information that can help optimise treatment when tumour

tissue is not available hellip The results have important implications for the use of cancer

therapies that target specific cancer mutations hellip Testing for the presence of these

mutations in the tumour itself is not always possible however studies have suggested that

DNA from the tumour that circulates in the bloodstream of patients may provide similar

information hellip Comparison of the outcomes of EGFR testing in the two techniques showed

an 89 rate of agreement between the blood test and tissue test Plasma testing identified

about half of the patients with EGFR mutations compared to tissue testing (a sensitivity of

46) EurekAlert

Drugs that activate brain stem cells may reverse multiple

sclerosis

20 April - Two drugs already on the market -- an antifungal and a

steroid -- may potentially take on new roles as treatments for

multiple sclerosis According to a study published in Nature today

researchers discovered that these drugs may activate stem cells in the

brain to stimulate myelin producing cells and repair white matter

which is damaged in multiple sclerosis hellip [Both] drugs were effective

in activating OPCs to enhance myelination and reverse paralysis As a

result almost all of the animals regained the use of their hind limbs They also found that

the drugs acted through two very different molecular mechanisms NIH

5

Ex-Googlers new breast cancer gene test cuts the cost to

women

21 April - hellip Tests for BRCA1 and BRCA2 typically cost

up to $4000 and insurance companies have strict

criteria when it comes to covering these tests

disqualifying many women who dont have a family

history of cancer at a young age or dont meet other

requirements hellip Color Genomics a new company hellip

hopes to make this type of genetic testing more affordable Their companys Color Test out

today is a mail-order at-home saliva test that costs $249 and tests 19 genes connected to

breast and ovarian cancer including BRCA1 and BRCA2 Mutations in those genes can

indicate a risk for breast and ovarian cancer many times greater than the national average

(in their lifetimes 12 of American women will develop breast cancer and 13 of

American women will develop ovarian cancer) These kinds of mutations also put women at

risk for cancer at a much younger age Early detection greatly increases five-year survival

rates from 25 for late-stage breast cancer to 98 for early-stage breast cancer If a

woman knows her risk she can pursue a range of optionsmdashincluding close monitoring or

invasive prevention Fast Company


21 April - The brains of babies light up in a similar way to adults when exposed to the

same painful stimulus suggesting they feel pain much like adults do researchers said on

Tuesday In the first of its kind study using magnetic resonance imaging (MRI) scientists

from Britains Oxford University found that 18 of the 20 brain regions active in adults

experiencing pain were also active in babies Brain scans of the sleeping infants while they

were subjected to mild pokes on the bottom of their feet with a special rod -- creating a

sensation like being poked with a pencil -- also showed their brains had the same

response to a slighter poke as adults did to a stimulus four times as strong suggesting

babies have a much lower pain threshold Reuters


21 April - The lives of six boys with a deadly genetic disease have been transformed by a

pioneering treatment to correct errors in their DNA say doctors A defective immune

system in Wiskott-Aldrich syndrome leaves people vulnerable to infections and bleeding hellip

It all stems from an error in the genetic code that contains the building instructions for a

key element in the immune system - a protein called WAS The main treatment is a bone

marrow transplant - but that is an option only when the donor is a close tissue match such

as a sibling The trial at Great Ormond Street Hospital in London and Necker Childrens

Hospital in France removed part of the childrens bone marrow It was purified in the

laboratory to find the cells that regenerate the immune system and a tamed version of HIV

was used to infect the cells with the correct DNA The corrected bone marrow cells were

6

then put back into the children In six out of seven boys the therapy was a success It

reversed symptoms and massively cut the number of nights spent in hospital BBC News

Global pandemic of fake medicines poses urgent risk

scientists say

20 April - Poor quality medicines are a real and urgent threat that could undermine decades

of successful efforts to combat HIVAIDS malaria and tuberculosis according to the editors

of a collection of journal articles published today Scientists report up to 41 percent of

specimens failed to meet quality standards in global studies of about 17000 drug samples

Among the collection is an article describing the discovery of falsified and substandard

malaria drugs that caused an estimated 122350 deaths in African children in 2013 Other

studies identified poor quality antibiotics which may harm health and increase antimicrobial

resistance However new methodologies are being developed to detect problem drugs at

the point of purchase and show some promise scientists say Scientists inspected the

quality of about 16800 samples of anti-malarials anti-tuberculosis medicines antibiotics

and anti-leishmaniasis drugs and reported from 9 to 41 percent failed to meet the

specifications NIH


22 April ndash Progress towards global vaccination targets for 2015 is far off-track with 1 in 5

children still missing out on routine life-saving immunizations that could avert 15 million

deaths each year from preventable diseases In the lead-up to World Immunization Week

2015 (24ndash30 April) WHO is calling for renewed efforts to get progress back on course In

2013 nearly 22 million infants missed out on the required three doses of diphtheria-tetanus-

pertussis-containing vaccines (DTP3) many of them living in the worldrsquos poorest countries

WHO is calling for an end to the unnecessary disability and death caused by failure to

vaccinate WHO


20 April - Rabies kills 59000 people a year or about 160 a day mdash more than had previously

been assumed mdash according to a study published last week The report based on

mathematical modeling is higher than previous estimates based on officially reported

deaths the authors said It was produced by the Global Alliance for Rabies Control and

published in PLoS Neglected Tropical Diseases Although India has the most rabies deaths

mdash almost 21000 a year mdash many African countries have higher per capita death rates China

also has a high death rate from rabies New York Times

Yet another study finds no link between MMR vaccine

autism

22 April - The alleged vaccine-autism connection has yet again been debunked In a large

retrospective cohort study of children with older siblings the measles-mumps-rubella

7

(MMR) vaccine was shown to not be associated with autism even in kids with an older

sibling with autism spectrum disorders (ASD) Writing in the Journal of the American Medical

Association (JAMA) yesterday US researchers said they analyzed data from 95727 children

994 of whom (1) were diagnosed as having ASD and 1929 of whom (2) had an older

sibling with ASD The investigators found that the receipt of MMR vaccine was not

associated with an increased risk of ASD at any age and regardless of sibling ASD CIDRAP

News Scan (first item)

EBOLA VIRUS DISEASE

Ebola lying in wait

20 April - A growing body of scientific clues mdash some ambiguous others substantive mdash

suggests that the Ebola virus may have lurked in the West African rain forest for years

perhaps decades before igniting the deadly epidemic that swept the region in the past

year taking more than 10000 lives Until recently Ebola had been considered a threat

mostly to Central African nations Yet studies tell of possible Ebola antibodies in human

blood samples drawn in West Africa long before the current outbreak And genetic analysis

suggests the West African virus broke off from a parent strain in Central Africa at least 10

years ago possibly as long as 150 years ago New York Times

WHO leadership admits failings over Ebola promises

reform

19 April - The World Health Organization has admitted serious failings in its handling of the

Ebola crisis and pledged reforms to enable it to do better next time its leadership said in a

statement seen by Reuters on Sunday We have learned lessons of humility We have seen

that old diseases in new contexts consistently spring new surprises said the statement

attributed to the WHO Director-General Margaret Chan and the deputy director-general

and regional directors hellip The statement also spelled out the WHOs plans to reform so that

it would be prepared for similar emergencies in future We can mount a highly effective

response to small and medium-sized outbreaks but when faced with an emergency of this

scale our current systems ndash national and international - simply have not coped hellip The

planned reforms include the establishment of a 1000- strong emergency reserve force a

contingency fund and a rapid-response force as well as a stronger command structure at

the WHO and stronger international health rules to make sure every country is up to

standard for disease preparedness Reuters

top of page

8

INFLUENZA

Armed Forces Health Surveillance Center DoD Seasonal

Influenza Surveillance Summary

For Week 14

NORTHCOM Influenza activity continues to decrease to baseline levels in most areas

However Indiana is still experiencing high activity levels

EUCOM Influenza activity continued to decrease as was at minimal to low levels

PACOM Moderate influenza activity was seen in Hawaii and there was minimal activity

throughout the rest of PACOM

CENTCOM and AFRICOM Influenza activity was minimal

SOUTHCOM Influenza activity remains low AFHSC DoD Seasonal Influenza Surveillance

Summary


During week 14 (April 5-11 2015) influenza activity continued to decrease in the United

States

Viral Surveillance Of 11189 specimens tested and reported by US World Health

Organization (WHO) and National Respiratory and Enteric Virus Surveillance System

(NREVSS) collaborating laboratories during week 14 1076 (96) were positive for

influenza

Pneumonia and Influenza Mortality The proportion of deaths attributed to pneumonia

and influenza (PampI) was below the epidemic threshold

Outpatient Illness Surveillance The proportion of outpatient visits for influenza-like

illness (ILI) was 18 which is below the national baseline of 20 Three regions

reported ILI at or above region-specific baseline levels FluView

DoD Global Laboratory-Based Influenza Surveillance

Program

During 29 March - 11 April 2015 (Surveillance Weeks 13 amp 14) a total of 105 specimens

were collected and received from 34 locations Results were finalized for 49 specimens from

27 locations During Week 13 the laboratory identified three influenza A(H3N2) and seven

influenza B During Week 14 five influenza B were identified USAF School of Aerospace

Medicine

Flu News Europe

Week 152015 (6-12 April 2015)

Influenza activity continued to decrease in most reporting countries the proportion of

influenza-virus-positive specimens from sentinel sources decreased from 36 for week

14 to 28 for week 15 Since week 512014 the positivity rate has been over the

9

threshold of 10 indicating seasonal influenza activity

Influenza A(H1N1)pdm09 A(H3N2) and type B viruses continued to circulate in the

WHO European Region but type B viruses accounted for 69 of sentinel detections for

week 152015

The number of hospitalised influenza cases is returning to low levels

Excess all-cause mortality among people aged 65 years and above concomitant with

increased influenza activity and the predominance of A(H3N2) viruses had been

observed in most countries participating in the European project for monitoring excess

mortality for public health action (EuroMOMO) but has now abated (see the

EuroMOMO website)

Antigenic drift in the A(H3N2) and BYamagata viruses was observed in the 2014ndash2015

influenza season so the northern hemisphere vaccine did not provide optimal

protection against the A(H3N2) viruses The BYamagata component in the vaccine is

likely to protect against the circulating viruses

Of all the influenza viruses screened for reduced susceptibility to neuraminidase

inhibitors only four A(H3N2) viruses have shown this phenotype three to oseltamivir

only and one to oseltamivir and zanamivir Flu News Europe

Naval Health Research Center Febrile Respiratory

Illness Surveillance Update

For Week 15 (through 18 April 2015)

Influenza Two cases of NHRC laboratory-confirmed influenza one (AH3) and one type

B among US military basic trainees Decreasing influenza activity at US military recruit

sites

FRI surveillance at all eight US military basic training centers indicated FRI rates were at

or below expected values NHRC Febrile Respiratory Illness Surveillance Update


For the Week Ending 11 April 2015 (Week 14)

Influenza activity in Army and civilian populations as well as the number of respiratory

specimens tested continue decreasing

ILI activity Army incident ILI outpatient visits in week fourteen were 8 lower than in

week thirteen

Influenza cases 4 hospitalized influenza cases were reported to USAPHC in weeks

thirteen and fourteen 2 active duty (AD) Service members (SMs) who were vaccinated

and 2 non-AD beneficiaries who were not vaccinated To date 95 cases have been

reported during this influenza season 25 AD SM and 70 non-AD beneficiaries

Viral specimens During week fourteen 98 of 518 (19) laboratory specimens tested

10

positive for respiratory pathogens 15 of 395 (38) specimens tested for influenza A

were positive SRMC reported the most influenza A-positive specimens (40) followed

by ERMC (33) NRMC and PRMC (both 13) and WRMC and CENTCOM (both 0)



20 April - Influenza activity declined further in the northern hemisphere and was low in most

regions globally While influenza A(H3N2) viruses predominated this season in the northern

hemisphere the proportions of influenza A(H1N1)pdm09 and B viruses increased during the

past few weeks

In North America influenza activity continued to decrease While influenza A(H3N2) had

predominated this season influenza B was the dominant virus during the recent weeks

In Europe influenza activity continued to decrease in most countries Influenza A(H3N2)

predominated this season but the proportion of influenza B detections was

predominant in the last weeks

In northern Africa and the Middle East influenza activity continued to decrease in most

of the region Influenza A viruses remained predominant in the region

In western Asia influenza activity continued to decrease or remained low in most

countries in the region with a predominance of influenza A viruses Influenza detections

however remained high or possibly increased in Jordan and Turkey

In the temperate countries of Asia influenza activity continued to decrease except in

the Republic of Korea where activity remained high Influenza A(H3N2) virus was

predominant with an increase of influenza B virus detections in the Republic of Korea In

northern China influenza B virus remained predominant but detections decreased

In tropical countries of the Americas influenza activity was low in most countries

In tropical Asia influenza activity mainly due to influenza A(H1N1)pdm09 viruses

seemed to be declining in India Influenza activity continued to decrease from its peak

in southern China where influenza B virus was predominant and in China Hong Kong

Special Administrative Region where influenza A(H3N2) virus was the most frequently

detected virus subtype

In tropical Africa increased influenza activity was reported from western Africa with a

mixture of influenza A(H1N1)pdm09 A(H3N2) and B viruses circulating Madagascar

reported decreasing influenza activity after experiencing increased influenza activity

from February with a peak at the beginning of March due to influenza A(H3N2) and B

In the southern hemisphere influenza activity remained at inter-seasonal levels WHO

top of page

11



20 April - hellip Pets can transmit dozens of diseases to humans

but doctors arent always as good as they should be in asking

about pets in the home and humans health issues a study

finds And that goes for people doctors and animal doctors

The fact that theyre equally uneducated is concerning says

Jason Stull an assistant professor of veterinary preventive

medicine at Ohio State University and lead author of the review hellip There hasnt been a

great dialogue between the veterinary community the human health community and the

public hellip People should be sure to let their human health-care providers know that they

have pets Stull says and let the vet know if there are family members who are at greater

risk of animal-borne infections That includes children under age 5 pregnant women older

people and anyone with a weakened immune system due to things like chemotherapy

HIVAIDS or organ transplants NPR

Goat plague hits poor farmers in Africa Asia wider

vaccination needed FAO

22 April - Goat plague a fast spreading virus impoverishes millions of small farmers across

Africa and Asia but a campaign to eradicate it has drawn far less support than halting mad

cow disease or Ebola a UN veterinary official said on Wednesday Peste des petits

ruminants (PPR) or goat plague attacks sheep and goats - crucial to the livelihood of more

than 300 million herders in the developing world - and costs those who can least afford it

some $2 billion a year the UNs Food and Agriculture Organisation (FAO) reported Despite

an effective vaccine which can protect animals PPR has spread rapidly in the past 15 years

into more than 60 countries it said Reuters


20 April - Veterinarians have long warned that pain medications like ibuprofen are toxic to

pets And it now looks like merely using a pain relief cream can put cats at risk Thats what

happened in two households according to a report issued Friday by the Food and Drug

Administration Two cats in one household developed kidney failure and recovered with

attention from a veterinarian But in a second household three cats died When the

veterinarians performed necropsies on the three dead cats they found toxic levels of

nonsteroidal anti-inflammatory drugs or NSAIDs NSAIDs include ibuprofen like Advil and

Motrin and naproxen which is in Aleve Ibuprofen is the most common drug that pets eat

according to the American Veterinary Medical Association perhaps since many of the pills

are candy-coated In pets the drugs can cause stomach or intestinal ulcers and kidney

failure But these cats died by flurbiprofen another NSAID In the case of its most recent

12

victims the cat owner applied a lotion or cream containing flurbiprofen to treat muscle or

arthritis pain NPR


21 April - Texas-based Blue Bell Creameries announced on Monday a voluntary recall of all

its ice cream and frozen treat products from store shelves due to continuing problems with

the Listeria bacteria The move is the most recent in a string of recall announcements by the

108-year-old company based in Brenham after health officials said last month three people

made ill by Listeria between January 2014 and January 2015 had died in a Kansas hospital

where Blue Bell frozen treats were served Mondays decision came after the bacteria was

detected in Chocolate Chip Cookie Dough ice cream samples that were tested last month

Reuters

top of page

WELLNESS


20 April - Two changes to the pain medication market the introduction of tamper-resistant

OxyContin and the removal of propoxyphene were followed by decreases in opioid

prescription-related overdoses and dispensation of these medications researchers reported

Two years after these two market interventions opioid-related overdoses dropped by 20

and opioid dispensation rates dropped by 19 from the expected rate of increase over a

decade hellip Abuse-deterrent mechanisms can only act as a component of a larger public

health strategy [Hillary] Kunins asserts These formulations will not prevent people

receiving high doses of opioids from overdosing [and] do not prevent the initial exposure

to opioids he added MedPage Today

A surge in federal funding for Mental Health First Aid

could make it as popular as CPR

19 April - hellip The Mental Health First Aid course advocates say could grow to be what CPR is

to heart attack victims The federal government has spent more than $20 million since 2013

to make the course available in local communities hellip You are far more likely to come

across someone having a mental health crisis or substance abuse disorder than a heart

attack or choking on the piece of food at a restaurant said Bryan Gibb director of public

education for the National Council for Community Behavioral Healthcare which manages

the course nationwide About 20 percent of people have a mental health issue Less than 1

percent have a heart attack each year hellip The eight-hour course teaches how to identify

symptoms such as depression and how and when to intervene It is typically offered through

county behavioral health departments to a variety of public service educational and

13

nonprofit workers and in some cases to the general public Mercury News


21 April ndash A mindfulness-based therapy could offer a

new choice for millions of people with recurrent

depression a Lancet report suggests Scientists tested it

against anti-depressant pills for people at risk of relapse

and found it worked just as well The therapy trains

people to focus their minds and understand that

negative thoughts may come and go hellip Patients who have had recurrent clinical depression

are often prescribed long-term anti-depressant drugs to help prevent further episodes And

experts stress that drug therapy is still essential for many In this study UK scientists

enrolled 212 people who were at risk of further depression on a course of mindfulness-

based cognitive therapy (MBCT) while carefully reducing their medication hellip Researchers

compared these results to 212 people who continued to take a full course of medication

over two years By the end of the study a similar proportion of people had relapsed in both

groups And many in the MBCT group had been tapered off their medication BBC News


20 April - Gov Mike Pence of Indiana extended a needle exchange program for another 30

days on Monday as the number of HIV cases linked to intravenous drug use in a rural

county continued to grow with new cases being reported almost daily Mr Pence a

Republican who has long opposed needle exchanges first authorized the program last

month when he declared a 30-day public health emergency in Scott County which has

about 24000 residents and is near the Kentucky border At the time about 80 people there

had tested positive for HIV since December But the number of cases has grown since then

to 128 and state health officials say they are still trying to find and test everyone who could

have been exposed to the virus New York Times


21 April - Women ages 18 to 25 who received the human papilloma virus (HPV) vaccine

before exposure to the virus are strongly protected against future infection at three risk-

prone anatomic sites And the vaccine appears to provide some protection even in those

previously exposed hellip Earlier studies have reported just on whether the vaccine is

protective against cervical HPV alone but we treated it as Does the vaccine protect an

individual woman against HPV at all three of her at-risk sites -- cervical anal and oral

Beachler told MedPage Today hellip We see a strong multi-site vaccine efficacy for those

unexposed to HPV prior to vaccination as we would expect -- but we also see that the

vaccine may provide some protection at one or more sites in women who were exposed to

HPV prior to vaccination said Beachler in a press conference MedPage Today

14


19 April - After 13 years of rejecting applications for new diet drugs the US Food and Drug

Administration in the last 3 years has allowed five potentially harmful products on the

market -- including two in the last 4 months The agency approved the drugs despite the

potential for serious side effects including suicidal thinking increased heart rate and cancer

risk and no proof the drugs improve the main health concern posed by obesity --

cardiovascular harms such as heart attacks Critics worry the new products will repeat the

diet-drug mistakes of the past which have led to decades of injuries deaths and in the

end products forced off the market The FDAs about-face comes after pressure from the

companies that manufacture the drugs medical societies that get funding from those drug

makers and even the US Senate -- where pharmaceutical money also finds takers -- which

in 2011 called on the FDA to approve new obesity treatments MedPage Today

top of page

USAFRICOM

Democratic Republic of the Congo Malaria outbreak in

South Kivu

20 April - A little reported malaria epidemic has been

quietly claiming childrenrsquos lives in the South Kivu province

of the Democratic Republic of Congo Although the disease

is endemic to the country this most recent outbreak has

been particularly severe in both scale and severity The MSF

supported hospital in Baraka has struggled to cope with the

endless stream of patients often children under five years old who are referred in need of

urgent intensive care Throughout 2014 MSF team in Baraka treated a record 89776

patients for malaria more than double the number of people treated the previous year

(42390) or the year previously (42305) Medecins Sans Frontieres

Libya Hundreds feared dead as boat capsizes off Libya

coast

20 April - As many as 700 people were feared dead after a fishing boat packed with

migrants capsized off the Libyan coast overnight in what officials said may be the

Mediterraneans worst disaster as thousands flee poverty and war to Europe The United

Nations High Commission for Refugees (UNHCR) said that around 50 people had been

rescued of the 700 reported to be aboard Maltese Prime Minister Joseph Muscat said the

rescue operation was continuing hellip Italian Prime Minister Matteo Renzi called for an

15

emergency meeting of European Union leaders this week saying We cannot remain

insensitive when every day there is a massacre in the Mediterranean The incident

happened in an area just off Libyan waters 193km south of Lampedusa island according to

a report in the Times of Maltas website This comes amid a wave of migrants trying to leave

Libya for Italian shores Al Jazeera

Niger shuts schools and vaccinates children to fight

meningitis outbreak

21 April - Niger has shut all schools in the region around the capital Niamey and launched a

campaign to vaccinate children aged two to 15 in an effort to halt a meningitis outbreak

that has killed at least 85 since January Schools will be closed from Wednesday until

Monday next week the government said adding that 905 cases of the disease had been

recorded most of them in Niamey and the west of the country A vaccination campaign

targeting children will start on Friday April 24 the statement said hellip Authorities said the

current outbreak included the W135 C strain and pneumococcal kinds of meningitis

Reuters

Nigeria Pesticide the likely cause of Nigeria mystery

disease

19 April - Pesticide poisoning was the likely cause of the mysterious deaths of at least 18

people in a southwestern Nigerian town earlier this week the World Health Organisation

said Sunday The current hypothesis is cause of the event is herbicides WHO spokesman

Gregory Hartl said in a Tweet Tests done so far are negative for viral and bacterial

infection he added The victims began showing symptoms early last week hellip The victims

whose symptoms included headache weight loss blurred vision and loss of consciousness

died within a day of falling ill in the town of Ode-Irele in southwestern Ondo state The

Ondo state health commissioner Dayo Adeyanju told AFP news agency on Saturday that 23

people had been affected Akinmade said health officials and experts from the government

and aid agencies as well as WHO epidemiologists had arrived in Ode-Irele to investigate

the deaths Al Jazeera


21 April - Every day trucks loaded with the narcotic plant khat grown in northeastern

Ethiopia hurtle along rough roads through the desert to make fresh deliveries to eager

customers across Somaliland Its estimated that 90 percent of adult males in the

autonomous region of Somaliland chew khat for mirqaan the Somali word for its euphoric

effect Khat has become so enmeshed with Somalilands culture and daily life it has become

an important tax earner for the government In 2014 khat sales generated 20 percent of the

$152m budget But despite this windfall plenty of critics highlight the disrupting influence

khat has on family life - from financial waste to domestic violence - and on the society at

large The problem comes down to the man not being part of the family and the woman

being left to do everything said Fatima Saeed a political adviser to the opposition Wadani

16

Party who previously worked for 15 years with the United Nations Al Jazeera


22 April ndash Local health officials have declared typhoid fever outbreak in Zanzibar

municipality after at least 22 residents were afflicted with the disease The number of

patients was recorded at Mnazi Mmoja hospital alone According to the head of the

diseases surveillance unit Dr Salma Masauni Yussuf patients suffered from headaches

recurring fever stomach pains and either constipation or diarrhoea that lasted for several

days AllAfrica


18 March - In a follow-up to earlier reports on the Uganda typhoid outbreak the World

Health Organization (WHO) via the Uganda Ministry of Health put the outbreak near 2000

cases since its genesis in Kampala at the beginning of the year As of 5 March 2015 a total

of 1940 suspected cases have been reported From the first epicentre in downtown

Kampala the outbreak has now spread to all divisions in the capital city and to neighboring

districts WHO reports The most affected groups are young males aged between 20 and 39

years The majority of cases work in the business sector or as casual labourers Food and

juice vendors and cooks are also affected hence the potential for wide spread of the

disease Outbreak News Today

top of page

USCENTCOM


17 April ndash The UN Security Council listened Thursday to Syrian doctors who attempted to

rescue children affected by alleged chlorine attacks in Idlib province of Syria Behind closed

doors Council members were shown footage of children dying following an alleged

chemical weapon attack in Sarmin near Idlib in northern Syria in March According to

international watchdog Human Rights Watch more than 200 civilians including 20 civil

defense workers were exposed to toxic chemicals in several barrel bomb attacks between

March 16 and 31 In a press conference following the meeting with the doctors US

representative to the UN Samantha Power said all members of the Security Council were

moved by the footage Power called for action against the Syrian regimes chemical attacks

by overcoming division at the fifteen-member council Al Bawaba

17


17 April - Dr Mohammed Tennari first saw the six

members of the Talib family when they were

carried into his cramped field hospital in northern

Syria on the night of March 16 They had been

taking refuge in the basement of their home in the

town of Sarmin when a barrel bomb filled with

chemical gases struck their house The gas being heavier than air quickly filtered down into

the basement poisoning the family Tennari and his team struggled to revive the three

small children their mother father and grandmother as life slipped away from them he

explained to me in a Skype call earlier this month from his field hospital in Sarmin

Everything smelled of bleach the doctor himself felt nauseous from the fumes and one of

the nurses fainted All six family members would die ldquoThere were no wounds no bleeding

they were just struggling to breatherdquo he said of the attack ldquoTheir lungs were filled with

liquid as well mdash it was suffocation to the point where the heart stopped beatingrdquo Foreign

Policy

Yemen WHO says warfare has left Yemens health

system near collapse

21 April - The World Health Organization (WHO) warned today that warfare in Yemen has

pushed the countrys health system to the brink of collapse as facilities struggle with

shortages of medicines and supplies along with power supply interruptions The agency said

lack of fuel has hindered the use of back-up power generators and has also disrupted

ambulance services and the delivery of supplies Power cuts and fuel shortages also

threaten to disrupt the vaccine cold chain leaving millions of children below the age of five

unvaccinated the WHO said in a statement hellip In addition shortages of clean water have

increased the risk of diarrheal and other diseases the agency said CIDRAP News Scan

(second item)

top of page

USEUCOM

Ukraine In rebel territory of Ukraine older residents

fight to live

15 April - hellip In November President Petro O Poroshenko signed an order that closed all

government institutions in areas of southeastern Ukraine under rebel control police

stations courthouses universities and hospitals As a result deliveries of drugs to regional

18

hospitals were also halted People with health problems could receive pensions and medical

treatment if they traveled across the front lines into government-held territory Russia has

demanded that Ukraine resume paying social benefits and health care costs in the

southeast but still recognize the autonomy of the separatist governments hellip Meanwhile

hospitals delay planned surgery because there are no anesthetics Diabetics are told to

travel across the front lines for treatment ldquoJust imagine a health care system without drugsrdquo

said Loic Jaeger the deputy director of the Ukraine mission for Doctors Without Borders

ldquoWith diabetes or heart problems it is easy to say someone will die if they donrsquot get their

medicinerdquo New York Times

top of page

USNORTHCOM

US Alabama Montgomery spice victim number climbs

to near 80

20 April - The weekend saw more spice cases under investigation by the Montgomery Police

Department Ten new cases were added to the growing list which now includes 79 patients

affected by the dangerous drug On Friday Montgomery Mayor Todd Strange confirmed

during a joint city-county-state news conference that the citys police department has

opened a death investigation that is possibly related to the latest batch of extremely

dangerous spice Mayor Strange did not provide specific details about the case but could

say the body was surrounded by spice materials An autopsy is being performed the

mayor confirmed Friday the city confirmed 72 victims who are suffering life-threatening

injuries from what is believed to be a particularly dangerous form of the drug That was up

more than a dozen cases in a single day Victims range in age from 14 to 50 years in age

and are mostly male WSFA

US Californians can now pay cash for health insurance

at 7-Eleven

21 April - The largest publicly run health plan in the nation LA

Care will allow customers who do not have traditional bank

accounts to pay their health insurance premiums with cash One

in four Americans who were previously uninsured and eligible

for federal insurance subsidies dont have a bank account

relying instead on prepaid debit cards money orders and cash

to pay bills according to a study by Jackson Hewitt Tax Service After advocates for low-

income consumers raised concerns to the Department of Health and Human Services over

how so-called unbanked households would pay their monthly insurance premiums the

19

Obama administration ordered health plans to accept payment methods that didnt require

a credit card or checking account NPR

US Occupational traumatic injuries among workers in

health care facilities mdash United States 2012ndash2014

24 April - In 2013 one in five reported nonfatal occupational injuries occurred among

workers in the health care and social assistance industry the highest number of such injuries

reported for all private industries In 2011 US health care personnel experienced seven

times the national rate of musculoskeletal disorders compared with all other private sector

workers A total of 112 US facilities reported 10680 OSHA-recordable patient handling

and movement (4674 injuries) slips trips and falls (3972 injuries) and workplace violence

(2034 injuries) injuries occurring from January 1 2012ndashSeptember 30 2014 Incidence rates

for patient handling slips trips and falls and workplace violence were 113 96 and 49

incidents per 10000 worker-months respectively Nurse assistants and nurses had the

highest injury rates of all occupations examined Morbidity and Mortality Weekly Report


20 April - hellip About 33 million Americans spent $29 billion on homeopathic treatments in

2007 according to the latest estimates from the Centers for Disease Control (CDC) though

private industry research suggests a smaller market The industry has mushroomed since

the early 1980s The FDA had the authority to regulate homeopathic remedies but

because sales were so small the agency opted to outsource much of that job to the

industry itself hellip [Cynthia] Schnedar acknowledges itrsquos time for the FDA to reevaluate that

policy ldquoWersquove seen a huge expansion of the market and wersquove also seen some emerging

safety and quality issuesrdquo she says She wouldnrsquot elaborate on changes the FDA is

considering but in its notice about the sessions the agency said it would seek data about

the risks and benefits of homeopathic products recommendations on regulatory processes

and would look into whether consumers have adequate information to make informed

decisions about such remedies BloombergBusiness


20 April - hellip What is Powassan virus DF It is a virus transmitted by tick-bite and was first

discovered in Powassan Ontario in 1958 The virus is normally transmitted among wildlife

(mammals) and humans get it when certain kinds of ticks become infected and later bite

humans It cannot be transmitted directly between humans as are many other diseases

caused by viruses What kind of disease does it cause DF Powassan virus attacks the

nervous system and can infect the brain causing inflammation a condition known as

encephalitis It can also infect the lining of the brain causing meningitis Symptoms of

infection range widely from none to death Serious infections can cause severe headache

muscle weakness confusion and seizures within a week or more after infection Long-term

neurological effects may also result Fatalities have been reported in 10 percent of cases

with serious neurological disease Fortunately most infections appear not to cause serious

20

illness Yale School of Public Health

US Top hospital ratings prove scarce in Medicares

latest tally

17 April - On Thursday the federal government awarded its first star ratings to hospitals

based on the opinions of patients Some of the nations most lofty hospitalsmdashthe ones

featured in best hospital listsmdashreceived mediocre ratings while the maximum number of

stars often went to small regional hospitals and others that specialize in lucrative surgeries

Evaluating hospitals is becoming increasingly important as more insurance plans offer

patients limited choices hellip Medicare publishes dozens of quality measures on its Hospital

Compare website but many are tough to decrypt hellip (You can see all hospital ratings here)

NPR

top of page

USPACOM

China Hundreds of Chinese cities donrsquot meet air

standards report finds

21 April - Air pollution data from the Chinese government

shows that more than 90 percent of 360 Chinese cities failed

to meet national air quality standards in the first three

months of this year according to a report released on

Tuesday by Greenpeace East Asia Interior provinces were

found to have the most polluted cities during those months

Cities near the eastern and southern coasts also had dire levels of fine pollutants but the

levels were lower than in the same period one year ago the report said The drop could be

because of central government policies announced in late 2013 aimed at limiting coal use in

Chinarsquos most densely populated regions New York Times


21 April - Two thousand girls are killed every day due to a preference for sons in India with

most aborted or murdered just after birth the countrys minister for women and child

development said Despite laws that ban parents from having tests to determine the gender

of unborn children sex-selective abortions remain a common practice in parts of India hellip A

May 2011 study in British medical journal The Lancet found that up to 12 million Indian girls

were aborted over the last three decades resulting in a skewed child sex ratio of 918 girls to

every 1000 boys in 2011 versus 962 in 1981 hellip [The] governments ldquoBeti Bachao Beti

Padhaordquo (Save the Daughter Educate the Daughter) campaign which aims to reverse the

21

declining number of girls had already shown results since its launch in January hellip [The]

campaign had led to an increase in unwanted girl infants ending up in orphanages but said

this was a positive response as it meant they had moved from being killed to being thrown

out VOA


22 April - A dramatic increase in deadly dengue fever has put nearly 150 people in hospital

in the past four months including one patient who died health officials in Mon State say Dr

Nyan Sint head of the state dengue haemorrhagic fever department said there were now

148 people in Mawlamyine hospital suffering from the fever Normally there are just a

handful of patients at any one time he said ldquoThe reasons for the increase are the rise in

population in urban areasrdquo he said also citing unplanned village development and climate

change Myanmar Times

top of page

USSOUTHCOM

Brazil seeing nearly half a million dengue cases in 1st

three months of 2015 enlists Armyrsquos support

18 April - Brazil has called up the Army but not for your typical war itrsquos a war on the

mosquito borne virus dengue fever which has seen a 240 percent increase compared to

the same period last year Officials in the countryrsquos largest city of Sao Paulo requested that

the army help in the battle against dengue where a surge of cases has brought the city tally

at 32000 and the state total is about half the countryrsquos total In addition 132 dengue

related fatalities have been reported in the first quarter [Soldiers will] accompany municipal

health officials in house-to-house inspections aimed at eradicating breeding areas for the

Aedes aegypti mosquito that transmits the disease Outbreak News Today


20 April - The number of chikungunya cases reported in the Americas grew by just 722

cases last week putting the total at 1372126 cases according to an Apr 17 update from

the Pan American Health Organization (PAHO) The increase is dramatically lower than

increases that have ranged from 13000 to 30000 in recent weeks Many countries though

have not reported to PAHO on their chikungunya situation in several weeks The total

reported last week reflects 1338240 suspected 30266 confirmed and 3620 imported

cases CIDRAP News Scan (third item)

22


21 April - The Department of Epidemiology of the Ministry of Health reported that Peru is

currently enduring an epidemic of dengue according to El Comercio Of the most affected

regions Piura Tumbes and Loreto have the highest rates of infection of the mosquito-

transmitted disease So far these regions have recorded 2603 2211 and 1362 cases of

dengue respectively These three regions alone represent 70 of all of Perursquos 8505 cases

reported so far The illness has taken the lives of four so far this year including two in Piura

and two in Tumbes While in 2014 31 people died and 19000 cases were reported in Peru

Peru this Week

top of page



The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical

intelligence product Medical intelligence is available from the National Center for Medical Intelligence

External Links The appearance of external hyperlinks does not constitute endorsement by the US Army of this Web site or the information products

or services contained therein For other than authorized activities such as military exchanges and MWR sites the US Army does not exercise any

editorial control over the information you may find at these locations Such links are provided consistent with the stated purpose of this product

Although Health Information Operations avoids links to sites that may be blocked all sites may not be accessible from all locations While we verify the

links at the time of publication we cannot guarantee that they will be active in the future

Articles appearing in the Update do not necessarily represent US Army Medical Department opinionsviews policy or guidance and should not be

construed or interpreted as being endorsed by the US Army Medical Department

The Army Public Health Weekly Update is published by the Health Information Operations Program Deputy Chief of Staff for Communication United

States Army Public Health Command

2

Performance Triad

The Total Family

Guide

The Total Family Guide to

enhancing your health with

sleep activity and nutrition

is now available for

download from the Health

Information Products

eCatalog


WELLNESS


A surge in federal funding for Mental Health First Aid could make it as popular as CPR





USAFRICOM

Democratic Republic of the Congo Malaria outbreak in South Kivu

Libya Hundreds feared dead as boat capsizes off Libya coast

Niger shuts schools and vaccinates children to fight meningitis outbreak

Nigeria Pesticide the likely cause of Nigeria mystery disease




USCENTCOM



Yemen WHO says warfare has left Yemens health system near collapse

USEUCOM

Ukraine In rebel territory of Ukraine older residents fight to live

USNORTHCOM

US Alabama Montgomery spice victim number climbs to near 80

US Californians can now pay cash for health insurance at 7-Eleven

US Occupational traumatic injuries among workers in health care facilities mdash United States

2012ndash2014



US Top hospital ratings prove scarce in Medicares latest tally

USPACOM

China Hundreds of Chinese cities donrsquot meet air standards report finds



USSOUTHCOM

Brazil seeing nearly half a million dengue cases in 1st three months of 2015 enlists Armyrsquos

support



3

Clinical Update

Multidrug-Resistant






develops






resistant bacteria



producing

Enterobacteriaceae


Asia where 80 of



antibiotics became






continue to shed




infection

US MILITARY





































4


the Weekly Update





USAPHC SIPRNet site

httpphcarmysmilmil


Current Issues


will need a SECRET


account

Links

A-Z Index

About USAPHC


Health Information



Monthly Report


(AKO)


USAPHC Resource

Materials

USAPHC Homepage

USAPHC Training

Contact USAPHC








Report

top of page

GLOBAL











46) EurekAlert


sclerosis










5


women






































6




scientists say












specifications NIH









vaccinate WHO










autism



7








EBOLA VIRUS DISEASE

Ebola lying in wait










reform














top of page

8

INFLUENZA



For Week 14








Summary



States




influenza







Program





Medicine

Flu News Europe

Week 152015 (6-12 April 2015)




9




week 152015






EuroMOMO website)













sites








week thirteen






10









past few weeks


























top of page

11






































12


arthritis pain NPR









Reuters

top of page

WELLNESS























13






































14













top of page

USAFRICOM


South Kivu












coast







15







meningitis outbreak








Reuters


disease























16








days AllAfrica











top of page

USCENTCOM












17
















Policy











(second item)

top of page

USEUCOM


fight to live




18










top of page

USNORTHCOM


to near 80













at 7-Eleven










19








































20



latest tally








NPR

top of page

USPACOM






















21




out VOA









top of page

USSOUTHCOM



















22









Peru this Week

top of page














3

Clinical Update

Multidrug-Resistant






develops






resistant bacteria



producing

Enterobacteriaceae


Asia where 80 of



antibiotics became






continue to shed




infection

US MILITARY





































4


the Weekly Update





USAPHC SIPRNet site

httpphcarmysmilmil


Current Issues


will need a SECRET


account

Links

A-Z Index

About USAPHC


Health Information



Monthly Report


(AKO)


USAPHC Resource

Materials

USAPHC Homepage

USAPHC Training

Contact USAPHC








Report

top of page

GLOBAL











46) EurekAlert


sclerosis










5


women






































6




scientists say












specifications NIH









vaccinate WHO










autism



7








EBOLA VIRUS DISEASE

Ebola lying in wait










reform














top of page

8

INFLUENZA



For Week 14








Summary



States




influenza







Program





Medicine

Flu News Europe

Week 152015 (6-12 April 2015)




9




week 152015






EuroMOMO website)













sites








week thirteen






10









past few weeks


























top of page

11






































12


arthritis pain NPR









Reuters

top of page

WELLNESS























13






































14













top of page

USAFRICOM


South Kivu












coast







15







meningitis outbreak








Reuters


disease























16








days AllAfrica











top of page

USCENTCOM












17
















Policy











(second item)

top of page

USEUCOM


fight to live




18










top of page

USNORTHCOM


to near 80













at 7-Eleven










19








































20



latest tally








NPR

top of page

USPACOM






















21




out VOA









top of page

USSOUTHCOM



















22









Peru this Week

top of page














4


the Weekly Update





USAPHC SIPRNet site

httpphcarmysmilmil


Current Issues


will need a SECRET


account

Links

A-Z Index

About USAPHC


Health Information



Monthly Report


(AKO)


USAPHC Resource

Materials

USAPHC Homepage

USAPHC Training

Contact USAPHC








Report

top of page

GLOBAL











46) EurekAlert


sclerosis










5


women






































6




scientists say












specifications NIH









vaccinate WHO










autism



7








EBOLA VIRUS DISEASE

Ebola lying in wait










reform














top of page

8

INFLUENZA



For Week 14








Summary



States




influenza







Program





Medicine

Flu News Europe

Week 152015 (6-12 April 2015)




9




week 152015






EuroMOMO website)













sites








week thirteen






10









past few weeks


























top of page

11






































12


arthritis pain NPR









Reuters

top of page

WELLNESS























13






































14













top of page

USAFRICOM


South Kivu












coast







15







meningitis outbreak








Reuters


disease























16








days AllAfrica











top of page

USCENTCOM












17
















Policy











(second item)

top of page

USEUCOM


fight to live




18










top of page

USNORTHCOM


to near 80













at 7-Eleven










19








































20



latest tally








NPR

top of page

USPACOM






















21




out VOA









top of page

USSOUTHCOM



















22









Peru this Week

top of page














5


women






































6




scientists say












specifications NIH









vaccinate WHO










autism



7








EBOLA VIRUS DISEASE

Ebola lying in wait










reform














top of page

8

INFLUENZA



For Week 14








Summary



States




influenza







Program





Medicine

Flu News Europe

Week 152015 (6-12 April 2015)




9




week 152015






EuroMOMO website)













sites








week thirteen






10









past few weeks


























top of page

11






































12


arthritis pain NPR









Reuters

top of page

WELLNESS























13






































14













top of page

USAFRICOM


South Kivu












coast







15







meningitis outbreak








Reuters


disease























16








days AllAfrica











top of page

USCENTCOM












17
















Policy











(second item)

top of page

USEUCOM


fight to live




18










top of page

USNORTHCOM


to near 80













at 7-Eleven










19








































20



latest tally








NPR

top of page

USPACOM






















21




out VOA









top of page

USSOUTHCOM



















22









Peru this Week

top of page














6




scientists say












specifications NIH









vaccinate WHO










autism



7








EBOLA VIRUS DISEASE

Ebola lying in wait










reform














top of page

8

INFLUENZA



For Week 14








Summary



States




influenza







Program





Medicine

Flu News Europe

Week 152015 (6-12 April 2015)




9




week 152015






EuroMOMO website)













sites








week thirteen






10









past few weeks


























top of page

11






































12


arthritis pain NPR









Reuters

top of page

WELLNESS























13






































14













top of page

USAFRICOM


South Kivu












coast







15







meningitis outbreak








Reuters


disease























16








days AllAfrica











top of page

USCENTCOM












17
















Policy











(second item)

top of page

USEUCOM


fight to live




18










top of page

USNORTHCOM


to near 80













at 7-Eleven










19








































20



latest tally








NPR

top of page

USPACOM






















21




out VOA









top of page

USSOUTHCOM



















22









Peru this Week

top of page














7








EBOLA VIRUS DISEASE

Ebola lying in wait










reform














top of page

8

INFLUENZA



For Week 14








Summary



States




influenza







Program





Medicine

Flu News Europe

Week 152015 (6-12 April 2015)




9




week 152015






EuroMOMO website)













sites








week thirteen






10









past few weeks


























top of page

11






































12


arthritis pain NPR









Reuters

top of page

WELLNESS























13






































14













top of page

USAFRICOM


South Kivu












coast







15







meningitis outbreak








Reuters


disease























16








days AllAfrica











top of page

USCENTCOM












17
















Policy











(second item)

top of page

USEUCOM


fight to live




18










top of page

USNORTHCOM


to near 80













at 7-Eleven










19








































20



latest tally








NPR

top of page

USPACOM






















21




out VOA









top of page

USSOUTHCOM



















22









Peru this Week

top of page














8

INFLUENZA



For Week 14








Summary



States




influenza







Program





Medicine

Flu News Europe

Week 152015 (6-12 April 2015)




9




week 152015






EuroMOMO website)













sites








week thirteen






10









past few weeks


























top of page

11






































12


arthritis pain NPR









Reuters

top of page

WELLNESS























13






































14













top of page

USAFRICOM


South Kivu












coast







15







meningitis outbreak








Reuters


disease























16








days AllAfrica











top of page

USCENTCOM












17
















Policy











(second item)

top of page

USEUCOM


fight to live




18










top of page

USNORTHCOM


to near 80













at 7-Eleven










19








































20



latest tally








NPR

top of page

USPACOM






















21




out VOA









top of page

USSOUTHCOM



















22









Peru this Week

top of page














9




week 152015






EuroMOMO website)













sites








week thirteen






10









past few weeks


























top of page

11






































12


arthritis pain NPR









Reuters

top of page

WELLNESS























13






































14













top of page

USAFRICOM


South Kivu












coast







15







meningitis outbreak








Reuters


disease























16








days AllAfrica











top of page

USCENTCOM












17
















Policy











(second item)

top of page

USEUCOM


fight to live




18










top of page

USNORTHCOM


to near 80













at 7-Eleven










19








































20



latest tally








NPR

top of page

USPACOM






















21




out VOA









top of page

USSOUTHCOM



















22









Peru this Week

top of page














10









past few weeks


























top of page

11






































12


arthritis pain NPR









Reuters

top of page

WELLNESS























13






































14













top of page

USAFRICOM


South Kivu












coast







15







meningitis outbreak








Reuters


disease























16








days AllAfrica











top of page

USCENTCOM












17
















Policy











(second item)

top of page

USEUCOM


fight to live




18










top of page

USNORTHCOM


to near 80













at 7-Eleven










19








































20



latest tally








NPR

top of page

USPACOM






















21




out VOA









top of page

USSOUTHCOM



















22









Peru this Week

top of page














11






































12


arthritis pain NPR









Reuters

top of page

WELLNESS























13






































14













top of page

USAFRICOM


South Kivu












coast







15







meningitis outbreak








Reuters


disease























16








days AllAfrica











top of page

USCENTCOM












17
















Policy











(second item)

top of page

USEUCOM


fight to live




18










top of page

USNORTHCOM


to near 80













at 7-Eleven










19








































20



latest tally








NPR

top of page

USPACOM






















21




out VOA









top of page

USSOUTHCOM



















22









Peru this Week

top of page














12


arthritis pain NPR









Reuters

top of page

WELLNESS























13






































14













top of page

USAFRICOM


South Kivu












coast







15







meningitis outbreak








Reuters


disease























16








days AllAfrica











top of page

USCENTCOM












17
















Policy











(second item)

top of page

USEUCOM


fight to live




18










top of page

USNORTHCOM


to near 80













at 7-Eleven










19








































20



latest tally








NPR

top of page

USPACOM






















21




out VOA









top of page

USSOUTHCOM



















22









Peru this Week

top of page














13






































14













top of page

USAFRICOM


South Kivu












coast







15







meningitis outbreak








Reuters


disease























16








days AllAfrica











top of page

USCENTCOM












17
















Policy











(second item)

top of page

USEUCOM


fight to live




18










top of page

USNORTHCOM


to near 80













at 7-Eleven










19








































20



latest tally








NPR

top of page

USPACOM






















21




out VOA









top of page

USSOUTHCOM



















22









Peru this Week

top of page














14













top of page

USAFRICOM


South Kivu












coast







15







meningitis outbreak








Reuters


disease























16








days AllAfrica











top of page

USCENTCOM












17
















Policy











(second item)

top of page

USEUCOM


fight to live




18










top of page

USNORTHCOM


to near 80













at 7-Eleven










19








































20



latest tally








NPR

top of page

USPACOM






















21




out VOA









top of page

USSOUTHCOM



















22









Peru this Week

top of page














15







meningitis outbreak








Reuters


disease























16








days AllAfrica











top of page

USCENTCOM












17
















Policy











(second item)

top of page

USEUCOM


fight to live




18










top of page

USNORTHCOM


to near 80













at 7-Eleven










19








































20



latest tally








NPR

top of page

USPACOM






















21




out VOA









top of page

USSOUTHCOM



















22









Peru this Week

top of page














16








days AllAfrica











top of page

USCENTCOM












17
















Policy











(second item)

top of page

USEUCOM


fight to live




18










top of page

USNORTHCOM


to near 80













at 7-Eleven










19








































20



latest tally








NPR

top of page

USPACOM






















21




out VOA









top of page

USSOUTHCOM



















22









Peru this Week

top of page














17
















Policy











(second item)

top of page

USEUCOM


fight to live




18










top of page

USNORTHCOM


to near 80













at 7-Eleven










19








































20



latest tally








NPR

top of page

USPACOM






















21




out VOA









top of page

USSOUTHCOM



















22









Peru this Week

top of page














18










top of page

USNORTHCOM


to near 80













at 7-Eleven










19








































20



latest tally








NPR

top of page

USPACOM






















21




out VOA









top of page

USSOUTHCOM



















22









Peru this Week

top of page














19








































20



latest tally








NPR

top of page

USPACOM






















21




out VOA









top of page

USSOUTHCOM



















22









Peru this Week

top of page














20



latest tally








NPR

top of page

USPACOM






















21




out VOA









top of page

USSOUTHCOM



















22









Peru this Week

top of page














21




out VOA









top of page

USSOUTHCOM



















22









Peru this Week

top of page














22









Peru this Week

top of page














24 April 2015 Army Public Health Weekly Update not ... Library... · 24 April 2015 Army Public...

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Transcript of 24 April 2015 Army Public Health Weekly Update not ... Library... · 24 April 2015 Army Public...